Kornimate/medical-research-clean huggingface dataset:
act-smart: smartphone-supplemented icbt for social phobia and/or panic disorder

Conditions: Panic Disorder; Phobic Disorders

Summary: background: smartphone technology presents a novel and promising opportunity to extend the reach of psychotherapeutic interventions by moving selected parts of the therapy into the real-life situations causing distress. this randomised controlled trial will investigate the effect of a transdiagnostic, internet-administered cognitive behavioural (icbt) self-help program for anxiety, supplemented with a tailored smartphone application. the effect of added therapist support will also be studied. methods/design: 150 participants meeting diagnostic criteria for social anxiety disorder and/or panic disorder will be evenly randomised to one of three treatment arms: (1) smartphone-supplemented icbt with therapist support; (2) smartphone-supplemented icbt without therapist support; or (3) an active waiting list control group with delayed treatment. after the 10 week treatment period, the control group (3) will receive the same treatment as group (2). primary outcome measure will be the generalised anxiety disorder 7-item self-rating scale. secondary measures include other anxiety, depression and quality of life measures. in addition to pre- and post-treatment measurements, the study includes two mid-treatment and two follow-up assessments (12 and 24 months). hypotheses: based on prior research, we hypothesise that the therapist-guided form will be superior to the unguided form in reducing anxiety levels, and that both delivery modes will be superior to an active waiting-list control group.


Eligibility criteria:
inclusion criteria: * satisfy dsm-iv-tr criteria for panic disorder and/or social anxiety disorder as assessed by the scid. * daily access to the internet via computer and smartphone * residing in sweden and speaking sufficient swedish to communicate with the research team exclusion criteria: * parallel psychological treatment * non-stable dosage of psychoactive medication during last 3 months * participants deemed to suffer from suicidal tendencies or another condition requiring specialized treatment
safety and effectiveness of cartiva implant in the treatment of first cmc joint osteoarthritis

Conditions: Osteoarthritis

Summary: this study will evaluate whether cartiva is an effective treatment for individuals with osteoarthritis of the cmc joint in the hand.

this is a prospective traditional feasibility study evaluating cartiva® sci for cmc for the treatment of first carpometacarpal joint osteoarthritis.the objectives of this clinical study are to evaluate the safety and effectiveness of cartiva® sci for cmc in terms of pain relief and improvement of joint function in the treatment of first cmc oa and to evaluate cartiva® sci for cmc device performance in order to establish the parameters for a pivotal trial. follow up visits will occur at the following time points after the surgical procedure: 14 days, 42 days, 90 days, 180 days, 1 year and 2 year. data will be summarized using descriptive statistics. continuous variables will be summarized using the number of observations, mean, standard deviation, median, and range as appropriate. categorical values will be summarized using the number of observations and percentages as appropriate. chi-square or fisher exact tests will be used for comparisons of categorical data. paired t-tests will used for the comparisons of continuous data. for statistical testing, an alpha of 0.05 is used as an acceptance standard and all testing are conducted as two tailed. also, 95% confidence intervals for mean values or proportion values will be provided as appropriate. since this is a feasibility study and no formal hypothesis is to be tested, p-values will be reported without adjustment for multiple comparisons. all analyses will be conducted using sas version 9.1 or later.

Eligibility criteria:
inclusion criteria: * ≥ 18 years of age * osteoarthritis of the first carpometacarpal joint * presence of good bone stock without the need for bone graft * capable of completing self-administered questionnaires exclusion criteria: * \< 18 years of age * active bacterial infection of the hand * previous cmc implant and/or surgery to the affected joint to be treated that would prevent implantation and fixation of cartiva® sci for cmc * patient has osteoarthritis of the scaphotrapeziotrapezoidal (stt) joint in the hand to be treated

Keywords: first cmc joint osteoarthritis cartilage replacement first cmc joint osteoarthritis damaged articular surface
multidimensional assessment and intervention for elder self-neglect

Conditions: Self-Neglect; Cognitive Ability, General; Geriatric Disorder

Summary: this study is designed to assess the best method for caring for elders reported to adult protective services (aps) for self-neglect. specifically, this study will compare aps usual care coupled with interdisciplinary comprehensive geriatric care to aps usual care alone in improving the health and quality of live among elders with substantiated self-neglect.


Eligibility criteria:
inclusion criteria: * 65 years of age or older * english speaking * resident of harris county, houston texas * community-dwelling * substantiated self-neglect exclusion criteria: * no other substantiated allegations * non-community dweller * no available for projected follow-up period * impaired decision-making with no available proxy * already receiving care from team or within the past year * terminal illness

Keywords: self-neglect comprehensive geriatric assessment (cga) geriatric syndromes quality of life basic activities of daily living instrumental activities of daily living
efficacy of tramadol with levobupivacaine for modified pectoral nerve block

Conditions: Breast Cancer; Radical Mastectomy Surgery

Summary: the aim of this study is to evaluate the addition of tramadol combined with levobupivacaine in the reduction of postoperative pain, postoperative opioid consumption after modified radical mastectomy surgery.

breast surgeries are usually associated with sever postoperative pain ,good perioperative analgesic technique after breast surgery is always questionable thoracic epidural and paravertebral blocks became the gold standard techniques for pain relief, however they may be associated with complications such as spinal cord injury, total spinal anesthesia ,inadvertent intravascular injection and pneumothorax. pecs block is less invasive procedure involving ultrasound guided inter-fascial injections which has been suggested as potential alternative analgesic technique. the block produces excellent analgesia and can be used as a rescue block in cases where the analgesia provided by the paravertebral or epidural was patchy or ineffective . different drugs, including opioids, non-steroidal anti-inflammatory drugs, ketamine, clonidine, and neostigmine, have been added to local anesthetics to improve the duration and quality of analgesia.tramadol has also been used for pain management of patients. the power of this clinical trial was prospectively calculated using the g power analysis program. using a priory power analysis with accuracy mode calculations with visual analogue score (vas) as the primary variant and assuming type i error protection of 0.05 and an effect size convention of 0.9, a total sample size of 54 patients (27 patients in each group) produced a power of 0.90. to protect against drop out cases we added 6 cases to the total number (total of 60 cases)

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists physical status i or ii. * patients scheduled for radical mastectomy surgery. exclusion criteria: * severe or uncompensated cardiovascular diseases * renal diseases * hepatic diseases * endocrinal diseases. * pregnancy * postpartum * lactating females * allergy to study medications. * local skin infection * bleeding disorder * coagulation abnormality * spine deformity * chest deformity * psychiatric disease
the sir-poba shunt trial

Conditions: Arteriovenous Fistula Stenosis

Summary: the goal of this clinical trial is to compare plain old balloon angioplasty with sirolimus-coated balloon angioplasty in patients with an arteriovenous shunt stenosis. the main question we aim to answer is, how patency is affected by each of the randomised treatment modality.

this clinical trial will be conducted at our division of vascular surgery and endovascular surgery at the university hospital of salzburg. patients will be randomized into one of the two treatment options (plain old ballon angioplasty versus sirolimus coated balloon angioplasty). the recruitment phase is calculated for two years with a planned follow-up of 2 years. follow-up data will be collected to answer the endpoints and will include all available follow-ups to monitor the shunt up to 2 years after the procedure. typically, follow-up visits will be conducted at 6 weeks, 3 months, 6 months, 12 months, and 24 months after the procedure. the shunts are checked for functionality as part of the dialysis required three times a week and presented to our department beforehand in need. this saves chronically ill patients the additional waiting time in hospital outpatient departments.

Eligibility criteria:
inclusion criteria: * age at least 18 years * informed consent with signature * maturated shunt, defined as already in use for two weeks * shunt stenosis in need of intervention exclusion criteria * pregnant or breastfeeding women * active infection or sepsis * incapacitated patients * lesions in the affected stenosis already pretreated by stenting in the same area shunt. * patients currently participating in another study * central venous stenosis worthy of treatment * intolerance to sirolimus * coagulopathy * radiotherapy * patients on immunosuppressive therapy * use of potent cyp3a4 and/or p-gp inhibitors (such as ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, or clarithromycin) or strong cyp3a4 and/or p-gp inducers (such as rifampin or rifabutin).
the impact of soft contact lenses on the corneal neuromediators and optical quality in high myopia prior to smile

Conditions: Contact Lens Complication

Summary: to investigate the influence of neuromediators expression in corneal stromal lenticules and corneal injury repair after small incision extraction

this study included 160 eyes from high myopia patients who underwent small incision lenticule extraction. patients were devided into three groups based on duration of wearing scls: \> 10 years group, ≤ 10 years group, and nw group (not scls). corneal higher-order aberrations and densitometry were evaluated using a pentacam system. neuromediator levels in corneal stromal lenticules were analyzed using elisa and immunofluorescence

Eligibility criteria:
inclusion criteria: * age ≥ 18 years with stable refraction for at least two years; * spherical equivalent (se) \< -6.00 d; * corrected distance visual acuity of 20/20 or better; * no history of using rigid gas permeable lenses or orthokeratology (ok) lenses prior to examination exclusion criteria: - a history of moderate to severe dry eye as well as any ocular or systemic disease that would contraindicate laser refractive surgery.

Keywords: corneal neuromediator soft contact lenses corneal optical density corneal aberration
robotic cytoreduction and hyperthermic intraperitoneal chemotherapy for treatment of gastric cancer with limited peritoneal metastasis, robo-chip study

Conditions: Gastric Adenocarcinoma; Gastroesophageal Junction Adenocarcinoma; Metastatic Malignant Neoplasm in the Peritoneum

Summary: this phase ii clinical trial tests how well robotic cytoreduction and hyperthermic intraperitoneal chemotherapy (hipec) in treating patients with gastric cancer that has spread to the tissue that lines the wall of the abdominal cavity (peritoneum). gastric cancer is the third leading cause of cancer related deaths worldwide and peritoneal metastasis are found in 30% of patients at time of diagnosis. patients with peritoneal metastasis have poor survival rates. traditional surgery is done with a large incision and has a high complication rate and longer hospital stays. robot assisted (robotic) cytoreduction is a surgical option that uses small incisions and there is less risk of complications. hipec involves infusing heated chemotherapy into the abdominal cavity during surgery. robotic cytoreduction together with hipec may improve recovery and decrease complications after surgery.


Eligibility criteria:
inclusion criteria: * restricted to 18 to 80 years of age * eastern cooperative oncology group (ecog) performance status =\< 2 * histologic confirmation of gastric adenocarcinoma including all subtypes and siewert type ii/iii gastroesophageal (ge) junction adenocarcinomas * absolute neutrophil count \>= 1,500 / ul * platelets \>= 50,000 / ul * serum creatinine \<= 1.5 mg / dl * adequate nutritional status (albumin \>= 3.5) * metastasis confined to the peritoneum: * positive peritoneal cytology * peritoneal metastasis on diagnostic laparoscopy * peritoneal metastasis on imaging * response to systemic chemotherapy defined as at least one of the following: * reduction (\>= 30%) in standardized uptake value (suv) max \[response evaluation criteria in solid tumors (recist) criteria\] * reduction in size of primary tumor, regional lymph node or peritoneal metastasis on imaging (\>= 20% decrease in the longest diameter of target lesion) recist criteria * reduction ( \>= 30%) in peritoneal carcinomatosis index (pci) or conversion of peritoneal cytology * reduction ( \>= 30%) in serum tumor markers cea or ca 19-9 * peritoneal carcinomatosis index (pci) =\< 7 and surgeon deems high likelihood for a complete cytoreduction * body mass index (bmi) =\< 35 kg/m\^2 exclusion criteria: * distant metastatic disease not limited to peritoneum, such as solid organ metastases (liver, lung, bone, distant lymph node, etc) * malignant ascites at time of study enrollment * comorbidities that would preclude protocol therapy * subjects deemed unable to comply with study and/or follow-up procedures * subjects with a known hypersensitivity to protocol systemic chemotherapy that was life-threatening, required hospitalization or prolongation of existing hospitalization, or resulted in persistent or significant disability or incapacity
biobehavioral efficacy of the semi-elevated side-lying position

Conditions: Feeding, Bottle; Infant, Premature, Diseases; Behavior, Infant

Summary: the objective of the proposed research is to conduct a within-subject cross-over trial that will compare the efficacy of the two bottle-feeding positions on physiologic and behavioral responses of preterm infants prior to, during, and after feeding. as an exploratory aim, the investigators will also identify potential infant characteristics associated with the intervention response by evaluating infant sex, maturity level, and/or comorbidity. the two bottle-feeding positions will be the semi-elevated side-lying position (hereafter referred to as side-lying position) and the semi-elevated supine position (hereafter referred to as supine position), which is the traditional feeding position when preterm infants are bottle-fed. the investigators hypothesize that compared to the supine position, the side-lying position will be associated with greater physiologic stability in heart rate, respiratory rate, oxygen saturation, and/or autonomic nervous system regulation during and after feeding. the investigators also hypothesize that compared to the supine position, the side-lying position will be associated with more mature patterns of suck-breathe coordination and/or greater feeding skills.


Eligibility criteria:
inclusion criteria: * preterm infants who are born at ≤ 35 weeks of ga exclusion criteria: * congenital anomaly that may interfere with feeding (e.g., cleft palate or tracheoesophageal fistula) * grade iv intraventricular hemorrhage * ventilator-dependence beyond 60 days of life * inability to orally feed prior to discharge
machine learning assisted recognition of out-of-hospital cardiac arrest during emergency calls.

Conditions: Out-Of-Hospital Cardiac Arrest

Summary: emergency medical services copenhagen has developed a machine learning model that analyzes the calls to 1-1-2 (9-1-1) in real time. the model are able to recognize calls where a cardiac arrest is suspected. the aim of the study is to investigate the effect of a computer generated alert in calls where cardiac arrest is suspected. the study will investigate 1. whether a potential increase in recognitions is due to machine alerts or the increased focus of the medical dispatcher on recognizing out-of-hospital cardiac arrest (ohca) when implementing the machine 2. if a machine learning model based on neural networks, when alerting medical dispatchers will increase overall recognition of ohca and increase dispatch of citizen responders. 3. increased use of automated external defibrillators (aed), cardiopulmonary resuscitation (cpr) or dispatch of citizen responders in cases of ohca on machine recognised ohca vs. medical dispatcher recognised ohca.

chances of survival after out-of-hospital cardiac arrest decrease 10% per minute from collapse until cpr is initiated. dispatcher assisted telephone cpr will be initiated only in cases where the dispatcher recognizes the cardiac arrest. in a previous project "can a computer through machine learning recognise of out-of-hospital cardiac arrest during emergency calls" (supported by trygfoundation), the investigators found, it was possible to create a machine learning (ml) model, which could recognise ohca with higher precision than medical dispatchers at the emergency medical dispatch center (emdc-copenhagen). in this study the model andt is effect is to be documented in the emdc-copenhagen. for this purpose, a computer server running the ml-model are created. this server is integrated in the network at emdc-copenhagen, making it possible to push alerts to the medical dispatcher, when a cardiac arrest is recognised by the model. with aid of machine learning, the hypothesis is, that recognition of ohca is improved, and happen both more frequent and faster than present. an instruction for the medical dispatchers is developed, which guides the medical dispatcher in instance of an alert from the machine.

Eligibility criteria:
inclusion criteria: * call regarding a cardiac arrest registered in the national danish cardiac arrest registry * ohca is recognized by machine-learning model * call originates from 1-1-2 exclusion criteria: * ohca emergency medical services - witnessed * call is from another authority (police or fire brigade) * call is a repeat call * call has been on hold for conference

Keywords: machine learning artificial intelligence dispatcher assisted telephone cpr heart arrest heart diseases cardiovascular diseases
gd-eob-dtpa-enhanced t1 map for predicting postoperative liver failure

Conditions: Liver Failure

Summary: researchers designed this study to compare the value of the conventional circular region-of-interest (roi) and whole-liver histogram-based analysis on gadoxetic acid disodium (gd-eob-dtpa)-enhanced t1 map for predicting postoperative liver failure (phlf). researchers collected and analyzed the data of patients who underwent partial hepatectomy for focal liver lesions. researchers drew circular rois on gd-eob-dtpa-enhanced t1 maps to get the mean t1 values. researchers used a multiparametric analysis software to get histogram parameters. then researchers compared the differences of these parameters between the phlf group and non-phlf group.

the objective of this study is to compare the value of the circular region-of-interest (roi) and whole-liver histogram-based analysis on gadoxetic acid disodium (gd-eob-dtpa)-enhanced t1 map for predicting postoperative liver failure. forty patients who underwent partial hepatectomy for focal liver lesions were retrospectively analyzed. all subjects underwent 1.5t gd-eob-dtpa-enhanced mri including pre-contrast and hepatobiliary-phase t1 mapping. patients were divided into two groups with (16 patients) and without (24 patients) postoperative liver failure according to the criteria established by the international study group for liver surgery (isgls). t1 values before enhancement (t1pre) and in the hepatobiliary phase (t1hbp) were measured by outlining a circular roi on the axial t1 maps. the reduction rate of t1 relaxation time (rrt1) = (t1 pre - t1hbp) / t1 pre. the whole-liver histogram analysis was performed using the prototype mr multiparametric analysis software (siemens healthcare, erlangen, germany). differences of the circular roi-based mean values and the histogram parameters between the two groups were compared. the receiver operating characteristic curve (roc) was plotted. the circular roi-based mean values and the histogram parameters for predicting phlf was assessed by the area under the curve (auc).

Eligibility criteria:
inclusion criteria: 1. underwent liver resection; 2. underwent gadoxetic acid-enhanced mri including, t1 mapping before and 20 minutes after gadoxetic acid administration within four weeks before the surgery ; 3. had an international normalized ratio (inr) and bilirubin examination on or after postoperative day five. exclusion criteria: 1. patients who had undergone non-resection treatment, including chemotherapy, radiofrequency ablation, percutaneous ethanol injection, or transarterial chemoembolization; 2. patients whose images had severe respiratory motion artifacts.

Keywords: gd-eob-dtpa hepatectomy liver failure magnetic resonance imaging